Fall 2019 Catalog (FINAL)

Registration FORM

PAYMENT MUST ACCOMPANY REGISTRATION

Cell #

Grade/School

Parent’s Name Home#

Work #

Address

City

Zip

Email Address

(needed for online account)

CODE NO.

TITLE

PARTICIPANT’S FIRST & LAST NAME

BIRTHDATE

M/F

FEE

c M c F c M c F

c M c F

c M c F

c M c F

c M c F

*Please list any allergies: List any assistance required:

TOTAL:

REGISTRATION POLICY: 1. Residents: Registration will begin Tuesday, August 6, 2019 , for all city residents. Non-Residents: Registration will begin Monday, August 12, 2019 , for those not living in the city limits. (All registrations are completed on a first come, first serve basis for this registration period.) 2. The Yorkville Parks & Recreation Department reserves the right to request proof of residence prior to processing a registration. Proof may be your City of Yorkville water bill, voter’s registration card or a driver’s license. 3. You may register for yourself and your immediate family ONLY. 4. Registration must be in ONE week before class starts, if not stated otherwise. 5. There is a $10.00 late fee for registration that may be accepted after the first day of class. REFUND POLICY: 1. NO refunds will be issued after a class has begun. Medical reasons excused with documentation; however, will be prorated according to attendance. 2. Participants will receive a full refund or credit if the Recreation Department cancels a program. 3. Cancellations for any class MUST be made at least 1 week prior to the beginning of class. 4. A $5.00 service charge will be deducted from all refund requests, and a program supply fee if applicable. (If program falls below the minimum required participants and the vacancy cannot be filled, no refund will be given). 5. Refund checks are mailed out approximately every two weeks, in conjunction with the bill list schedule. 6. NSF Fee of $35 will be charged for any returned checks. 7. All refunds for an athletic league (Adult or Youth) will only receive up to a 75% refund if the cancellation is made before the league is scheduled to begin. 8. No refunds for location or instructor change.

This form must be signed on the FRONT AND BACK by a legal adult/guardian and returned to the Recreation Office before class begins.

If registering by fax, your facsimile signature shall have the same legal effect as an original or electronic signature.

Return to: 201 W. Hydraulic Ave. Yorkville, IL 60560

Parent or Legal Guardian Signature

Date This registration form (including policies) and waiver form must be signed by all participating adults 18 years of age and older, and by a parent or guardian for each participant under age 18. Registration and waiver is posted on our website at www.yorkville.il.us.

OFFICE USE ONLY:

*PHONE REGISTRATION—Completed by: ______________ Policies read to customer: ______________ (initial)

Rec Trac __________ Receipt __________ Waitlist __________ Credit Card Processed __________ Signed __________ Mailed _________ Purge ________

Check #

Cash

Paid Waitlist

Credit Card Holder Signature Charge to: c MasterCard

c Visa

c Discover

c American Express

Charge Card Account Number

Exp. Date

33

YORKVILLE PARKS AND RECREATION DEPARTMENT – CONTACT US AT RECREATION@YORKVILLE.IL.US OR 630-553-4357

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